Telford Court Nursing Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question as good. At this assessment the rating has remained the same. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment were effective because they checked and discussed people’s health, care, wellbeing and communication needs with them. Where possible, staff undertook face to face assessments of people prior to them coming to the home. Staff used this information to help meet their preferences and develop their care plans. In emergencies, assessment information was obtained by the provider. Whilst some people were unable to recall being involved in an assessment, others told us staff discussed their needs and showed them around before they moved in. One relative told us, “Staff have the skills to manage (relatives) care. I was initially involved in the risk assessment and care plan.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. The provider used an electronic care planning system. Managers told us information was obtained and discussed with people and their relatives to help develop their care plans. However, not everyone we spoke with was aware they had seen their care plan. The provider used recognised assessment tools to identify people’s risks in areas such as skin integrity and nutrition. Staff had information about people’s care needs including their dietary needs and people received suitable food and drink. One person said, “The food is wonderful if I want extra or something different it’s not a problem.” Systems were in place to respond to any concerns in relation to weight loss. A visiting health professional told us nursing staff led the delivery of care with good clinical knowledge.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once. The registered manager had developed a specific staff role to support the transition of people moving to the home for further assessment and rehabilitation. We received positive feedback from a visiting professional, who told us the provider was flexible and worked effectively to support people especially in emergency situations. The local GP practice worked with the provider and carried out frequent visits to review people’s health needs. Feedback indicated staff had good clinical knowledge and experience and knew people and their families well. Staff told us they were kept up to date with any changes through daily handover meetings and staff meetings.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Staff supported people with the involvement of professionals such as dieticians and the mental health team, to help people to improve where possible. A relative commented, “[Relative] has a physio who visits regularly. I am kept up to date with appointments and follow ups from the home.”

Overall, the provider routinely monitored people’s care and treatment to continuously improve it. The management team monitored and audited clinical outcomes for people, such as in relation to infection or wounds and ensured action was taken to improve any issues. They ensured outcomes were positive and consistent, however, they had not always recorded when people’s care plan outcomes were discussed with them or their relatives. The provider used a ‘Resident of the day’ system to ensure people's care plans were reviewed monthly. However, people and their relatives were not always aware of being involved with care reviews. One relative said, “There’s no annual review of the care plan.” Staff generally communicated with people about their care, and people told us communication was good. A relative told us staff monitored their relative’s health condition closely and were very proactive. They commented, “I’ve no concerns. I know the care is good.” However, planned reviews which included people’s views, were not always completed or recorded. We raised this with the registered manager who agreed to address this.

Records did not always confirm the provider had told people about their rights around consent. Overall, staff obtained consent from people and respected their right to refuse. Where people lacked the capacity to decide about certain decisions, staff had recorded assessments and best interest decisions, such as for the use of bed rails. However, records needed to be clearer about people’s consent to accept their care plan and other decisions such as close observation. Records showed relatives had been consulted with, but these was not always recorded fully as a best interest decision in line with the Mental Capacity Act. People’s rights were however protected as Deprivation of Liberty Safeguards (DoLS ) applications had been appropriately submitted to the local authority. CCTV had been installed in some communal areas of the home. The registered manager ensured people were made aware and consented to this or a best interest decision was made as they moved in. However, the provider’s policies were not fully reflective of all aspects of the use of recording equipment. During our assessment the registered manager updated these and provided an impact assessment in line with best practice, these demonstrated how people’s privacy would be respected.